Public Document Depository Program

Public Document Depository Program

Annual Publications Report Form

All Louisiana state agencies, as defined by R.S. Title 25: §121.1,are required toreport the agency’s publications to the Recorder of Documents.Submit this completed formannually during the month of July by email or send it via fax, mail, or hand-delivery to the address given at the bottom of this form.

Note:list each title only once, even if multiple issues were published during the twelve month period (July 1-June 30) covered by the report (e.g., list “Minutes” only once, even if published quarterly).

If a publication changes significantly (e.g., changes title, ceases publication) during the year, please promptly submit thePublication Update Form, available from the Recorder’s web page for agencies at

Agency Name: / Terrific State Agency / Today’s Date: / 7/14/2017
Your Name: / Ms. Jane X / Job Title: / Director of Something Services
Email: / / Are you the liaison officer for this agency? / Yes No
Phone: / 504-123-5678
Liaison Name: / Liaison Job Title:
Liaison Email: / Liaison Phone:
Secondary Contact Name: / Mr. Bob Y / Secondary Contact Job Title: / Administrative Assistant
Secondary Contact Job Email: / / Secondary Contact Phone: / 504-123-5679
Publication Title: / Select Frequency From Dropdown Menu: / Check All Format(s) Published During Reporting Period:
Minutes of board meetings / Monthly / Hard Copy Digital
Journal of Louisiana Something / Quarterly / Hard Copy Digital
Annual report / Annually / Hard Copy Digital
Guide to Something Important / One time publication / Hard Copy Digital
Manual for Citizen Constituents / Irregularly--As often as needed / Hard Copy Digital
Quarterly Progress Report / Quarterly / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Publication Title: / Select Frequency From Dropdown Menu: / Check All Format(s) Published During Reporting Period:
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital
Choose an item. / Hard Copy Digital

Thank you for your continued support of the Louisiana Public Document DepositoryProgram.

Recorder of Documents

State Library of Louisiana

701 North 4th Street

Baton Rouge, LA 70802

Phone 225.342.4929

Fax 225.219.4804

PDDP State Agency Publications Report Form / Page 1 of 2